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Laparoscopic Subtotal Hysterectomy

Removing the Uterus

Kleppinger forceps circumferentially cauterize the vaginal fornices.

A monopolar cautery hook enters the vagina over the metal vaginal ring.

The uterosacral ligament on each side is cauterized before division.

The posterior vaginal cuff is cauterized with bipolar cautery before dividing it with a monopolar needle.

The cuff incision is carried around circumferentially until the entire uterus and cervix are freed from the vaginal cuff tissue.

The uterine manipulator is then used to withdraw the uterus out through the vagina.

The cuff may be closed transvaginally or by laparoscopic suturing.